Illicit Cannabis Usage as a Management Strategy in New Zealand Women with Endometriosis: An Online Survey

Armour, Mike; Sinclair, Justin; Noller, Geoff; Girling, Jane E.; Larcombe, Maria; Al-Dabbas, Mahmoud A; Hollow, Erika; Bush, Deborah; Johnson, Neil

doi:10.1089/jwh.2020.8668

Cited by 28 publications

(36 citation statements)

References 52 publications

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“…This compares to chemovars today often ranging in content between 15-30% THC, [34,35] usually at the expense of CBD content. This higher ratio of THC in illicit cannabis may have contributed to the pain reduction found in previous research [19,20] featuring an endometriosis cohort using illicit cannabis. However, the implied high absolute levels of THC may not be needed to gain optimal symptom control, as lower doses are readily implemented via inhaled dose titration.…”

Section: Discussionmentioning

confidence: 68%

“…[25,26] It may also be due to changes in pain perception that occur over time in people with endometriosis. [27,28] The preferred dosage form in previous research investigating illicit cannabis usage in endometriosis cohorts in Australia and New Zealand was via the inhaled route (including smoked and vapourised), with 61.9% of Australian [19] and 67.8% of New Zealand [20] respondents favouring this method of administration. Whilst it is plausible that inhaled forms are favoured within illicit markets due to a scarcity of other dosage forms, such a similarity within our legal cannabis dataset suggests other factors may be involved in the choice to use inhaled forms.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, another factor favouring the inhaled route is that women have previously reported that they have chosen inhaled forms due its ease of dose control, in order to titrate a balance between pain relief and impairment. [33] Lastly, women may be favouring inhaled dosage forms due to familiarity from previous recreational use, [19,20] with smoked cannabis being the most common method of administration historically. [34] The effect of changing the THC:CBD ratio appeared to have only a minor impact on pelvic pain, suggesting that a precise titration of THC is important for symptom management, but that higher levels may overly impair or increase known side-effects, potentially causing issues with participants being able to perform Activities of Daily Living (ADL).…”

Section: Discussionmentioning

confidence: 99%

“…[18] Previous research on the use of illicit cannabis in women with endometriosis has shown promise in the treatment of endometriosis pain and co-morbid symptoms such as poor sleep, gastrointestinal upset and mood disorders. [19][20][21] However, these ndings were all based on self-reported data and could not be reliably used to determine the relative effectiveness of different modes of cannabis administration, dose amount, cannabinoid ratios, or other determining factors (such as patient age), all of which may in uence clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms.

Sinclair¹,

Collett²,

Abbott

et al. 2021

Preprint

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Background The use of cannabis for symptoms of endometriosis was investigated utilising retrospective archival data from Strainprint Technologies Ltd., a Canadian data technology company with a mobile phone application that tracks a range of data including dose, mode of administration, chemovar and their effect on various self-reported outcomes, including pelvic pain. Methods A retrospective, electronic record-based cohort study of Strainprint™ users with self-reported endometriosis was conducted. Self-rated cannabis efficacy, defined as a function of initial and final symptom ratings, was investigated across the included symptom clusters of cramps, pelvic pain, gastrointestinal pain, nausea, depression, and low libido. Cannabis dosage form, dose and cannabinoid ratio information was also recorded. Results A total number of 252 participants identifying as suffering endometriosis recorded 16193 sessions using cannabis between April 2017 and February 2020. The most common method of ingestion was inhalation (n = 10914, 67.4%) with pain as the most common reported symptom being treated by cannabis (n = 9281, 57.3%). Gastrointestinal symptoms, though a less common reason for cannabis usage (15.2%), had the greatest self-reported improvement after use. Inhaled forms had higher efficacy for pain, while oral forms were superior for mood and gastrointestinal symptoms. Dosage varied across ingestion methods, with a median dose of 9 inhalations (IQR 5 to 11) for inhaled dosage forms and 1 mg/mL (IQR 0.5 to 2) for other ingested dosage forms. The ratio of THC to CBD had a statistically significant, yet clinically small, differential effect on efficacy, depending on method of ingestion. Conclusions Cannabis appears to be effective for pelvic pain, gastrointestinal issues and mood, with effectiveness differing based on method of ingestion. The greater propensity for use of an inhaled dosage delivery may be due to the rapid onset of pain-relieving effects versus the slower onset of oral products. Oral forms appeared to be superior compared to inhaled forms in the less commonly reported mood or gastrointestinal categories. Clinical trials investigating the tolerability and effectiveness of cannabis for endometriosis pain and associated symptoms are urgently required.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms.

Sinclair¹,

Collett²,

Abbott

et al. 2021

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…The preferred dosage form in previous research investigating illicit cannabis usage in endometriosis cohorts in Australia and New Zealand was via the inhaled route (including smoked and vapourised), with 61.9% of Australian [ 20 ] and 67.8% of New Zealand [ 21 ] respondents favouring this method of administration. Whilst it is plausible that inhaled forms are favoured within illicit markets due to a scarcity of other dosage forms, such a similarity within our legal cannabis dataset suggests other factors may be involved in the choice to use inhaled forms.…”

Section: Discussionmentioning

confidence: 99%

Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background The use of cannabis for symptoms of endometriosis was investigated utilising retrospective archival data from Strainprint Technologies Ltd., a Canadian data technology company with a mobile phone application that tracks a range of data including dose, mode of administration, chemovar and their effects on various self-reported outcomes, including pelvic pain. Methods A retrospective, electronic record-based cohort study of StrainprintTM users with self-reported endometriosis was conducted. Self-rated cannabis efficacy, defined as a function of initial and final symptom ratings, was investigated across the included symptom clusters of cramps, pelvic pain, gastrointestinal pain, nausea, depression, and low libido. Cannabis dosage form, dose and cannabinoid ratio information was also recorded. Results A total number of 252 participants identifying as suffering endometriosis recorded 16193 sessions using cannabis between April 2017 and February 2020. The most common method of ingestion was inhalation (n = 10914, 67.4%), with pain as the most common reported symptom being treated by cannabis (n = 9281, 57.3%). Gastrointestinal symptoms, though a less common reason for cannabis usage (15.2%), had the greatest self-reported improvement after use. Inhaled forms had higher efficacy for pain, while oral forms were superior for mood and gastrointestinal symptoms. Dosage varied across ingestion methods, with a median dose of 9 inhalations (IQR 5 to 11) for inhaled dosage forms and 1 mg/mL (IQR 0.5 to 2) for other ingested dosage forms. The ratio of THC to CBD had a statistically significant, yet clinically small, differential effect on efficacy, depending on method of ingestion. Conclusions Cannabis appears to be effective for pelvic pain, gastrointestinal issues and mood, with effectiveness differing based on method of ingestion. The greater propensity for use of an inhaled dosage delivery may be due to the rapid onset of pain-relieving effects versus the slower onset of oral products. Oral forms appeared to be superior compared to inhaled forms in the less commonly reported mood or gastrointestinal categories. Clinical trials investigating the tolerability and effectiveness of cannabis for endometriosis pain and associated symptoms are urgently required.

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Cannabis use in endometriosis: the patients have their say—an online survey for German-speaking countries

Jasinski,

Voltolini Velho,

Sehouli

et al. 2024

Arch Gynecol Obstet

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Purpose Endometriosis is a chronic inflammatory disease that can cause various pain symptoms. Current therapy options do not always provide sufficient pain relief and often cause unpleasant side effects. Recent studies have shown that the endocannabinoid system is involved in the endometriosis pathophysiology, and using Cannabinoids may be a potential therapeutic option. We aimed to determine for the first time, the Cannabis use prevalence, self-rated effectiveness, and the possible reduction in medication in German-speaking countries. Methods A cross-sectional online survey was distributed through endometriosis support and advocacy groups on social media. German-speaking endometriosis patients aged ≤ 18, residing in Germany, Austria, and Switzerland were eligible to participate. Results Out of 912 participants who provided valid answers, 114 reported using cannabis for self-management. Cannabis was rated as the most effective self-management strategy to reduce symptom intensity (self-rated efficacy 7.6 out of 10). Additionally, ~ 90% of the participants were able to decrease their pain medication intake. The greatest improvement was observed in sleep (91%), menstrual pain (90%), and non-cyclic pain (80%). Apart from increased fatigue (17%), side effects were infrequent (≤ 5%). Conclusion At the time of the study, Cannabis consumption was still illegal in Germany, Austria, and Switzerland, with medical cannabis being rarely prescribed due to complex requirements. Results suggest that Cannabis has become a popular self-management method for treating endometriosis-related symptoms, leading to substantial symptom improvement. Further studies are needed to investigate the best administration methods, dosage, THC/CBD ratio, potential side effects, and long-term effects to provide official recommendations to patients and healthcare providers.

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Illicit Cannabis Usage as a Management Strategy in New Zealand Women with Endometriosis: An Online Survey

Cited by 28 publications

References 52 publications

Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms.

Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms.

Effects of cannabis ingestion on endometriosis-associated pelvic pain and related symptoms

Cannabis use in endometriosis: the patients have their say—an online survey for German-speaking countries

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